The present 5 year application is a competing continuation of Grant No. P50DA07700 entitled, """"""""Center for Therapeutic Community Evaluation Research (CTCR)"""""""". The general mission of CTCR is to advance scientific knowledge of the therapeutic community (TC) approach to the treatment of chemical dependency and related problems. The major aims of CTCR are to: 1) conduct a program of treatment research and evaluation/studies of therapeutic communities, 2) promote evaluation and research capability within the TC modality, and 3) disseminate research findings to improve treatment programming and clinical practice. The mission and major aims remain unchanged in this competing renewal, although the proposed activities expand on the work conducted in the current grant period. The proposed CTCR field research studies will focus upon common issues, such as the effectiveness of modified TCs, aftercare, comorbidity, and the stability of long-term outcomes, Two studies of mentally ill chemical abusers (MICA) will provide the first results on the efficacy of modified TCs implemented for MICA inmates in prison (N=<600>) and for homeless MICA clients in a hospital based shelter setting (N=<300>), and will experimentally assess the impact of TC and non-TC oriented aftercare on treatment outcomes. The third study, a continuation of the current Adolescent project, will conduct the first large scale (N=<500>) long term, longitudinal follow-up (3-5 years post-treatment) of adolescent substance abusers treated in TCs. Its extended scope and depth will clarify the contribution of treatment, developmental, and non-treatment influences on the stability of outcomes among various subgroups of high risk adolescents (comorbidity, gender, and criminal/social deviance.) The CTCR core program includes research, training and dissemination activities. The current research initiative on treatment process will be advanced; developing field testing instrumentation and testing the generality of a TC process paradigm across the studies. CTCR training and dissemination activities will be substantially enhanced through a formal collaboration with the Nathan Kline Institute for Psychiatric Research (NKI). The Division of Alcohol and Drug Abuse administers the Center for Medical Fellowships in Alcoholism and Drug Abuse has liaisons with other professional disciplines and expanded dissemination capability participating in a world wide computer network for research and educational information transmission. The combined training and education resources of NKI and National Development and Research Institutes will create new opportunities and initiatives for CTCR.
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